陈林　钟庆华　　李玲苇　　李志腾　　刘绮　　李以茂

[摘要] 目的 分析可視喉镜联合床旁支气管镜在尘肺病大容量全肺灌洗术中引导双腔气管插管临床应用。 方法 选取2017年2月至2019年2月行大容量全肺灌洗术的尘肺病患者80例，根据双腔气管插管引导方式不同分为对照组与研究组，每组各40例，对照组给予普通喉镜插管，研究组可视喉镜引导并给予床旁支气管镜定位，回顾分析两组患者的临床资料，对比两组一次性插管成功率、插管时间与不良反应，插管部位符合率进行统计学分析。 结果 研究组患者的一次插管成功率与插管时间，插管部位符合率均优于对照组，差异有统计学意义（P<0.05）;而研究组不良反应发生率低于对照组，差异有统计学意义（P<0.05）。 结论 可视喉镜联合床旁支气管镜在大容量全肺灌洗术治疗尘肺病中可有效缩短插管时间，提高一次成功率，插管部位符合率高，降低不良反应，具有显著的应用效果，提示可视化技术值得在尘肺病大容量全肺灌洗术中双腔气管插管临床推广使用。

[关键词] 可视喉镜;床边支气管镜;尘肺病;大容量全肺灌洗术;气管插管

[中图分类号] R967          [文献标识码] B          [文章编号] 1673-9701（2021）11-0112-03

Clinical application of visual laryngoscope combined with bedside bronchoscope in double-lumen endotracheal intubation during large-volume whole lung lavage for pneumoconiosis

CHEN Lin1   ZHONG Qinghua1   LI Lingwei1   LI Zhiteng2   LIU Qi1   LI Yimao1

1.Department of Anesthesiology，the Fifth People′s Hospital of Ganzhou in Jiangxi Province， Ganzhou   341000， China; 2.Department of Respiratory and Critical Care Medicine， the Fifth People′s Hospital of Ganzhou in Jiangxi Province， Ganzhou   341000， China

[Abstract] Objective To analyze the clinical application of double-lumen endotracheal intubation guided by visual laryngoscope combined with bedside bronchoscope in large-volume whole lung lavage for pneumoconiosis. Methods Eighty patients with pneumoconiosis who underwent large-volume whole lung lavage from February 2017 to February 2019 were selected for the study. According to the different intubations， they were divided into the control group and the study group， with 40 cases in each group. The control group was given general laryngoscope-guided intubation， while the study group received visual laryngoscope combined with bedside bronchoscope. The clinical data of the two groups were analyzed retrospectively. The success rate of one-time intubation， intubation time and adverse reactions were compared between the two groups， and the coincidence rate of intubation site was analyzed statistically. Results Compared with the control group， the one-time success rate of intubation， intubation time， and the coincidence rate of intubation position were better in the study group， and the differences were statistically significant（P<0.05）， while the incidence of adverse effects was lower in the study group than in the control group， and the difference was statistically significant（P<0.05）. Conclusion Visual laryngoscope combined with bedside bronchoscope can effectively shorten the intubation time， improve the one-time success rate， the coincidence rate of intubation position and reduce the adverse reactions of patients， which indicates that visualization technology is worth popularizing in the clinical application of double-lumen endotracheal intubation in the treatment of pneumoconiosis.

[Key words] Visual laryngoscope; Bedside bronchoscope; Pneumoconiosis; Large volume whole lung lavage; Tracheal intubation

尘肺病是我国一个常见的职业疾病，进入肺部的粉尘约有97%以上能够顺利排出，唯有1%～3%的粉尘长久蓄留在肺部，这是诱发尘肺病的一个关键因素。大容量全肺灌洗在临床治疗中的原理是根据尘肺病患者的实际并结合肺部粉尘性、炎性细胞型肺泡炎等进行针对性治疗，不适应肺纤维化的治疗。在临床应用方面，大容量全肺灌洗能够有效地清除肺泡腔、支气管内的粉尘、细胞碎片、致纤维化因子等，能够达到消除病因、增强呼吸功能、改善症状的目的。不过在该技术实际应用过程中，需要对患者实施全身麻醉处理，插入双腔支气管导管，方可确保治疗过程的顺利和有效。……